Is every sharply defined, symmetrical, necrotic-demyelinating lesion in the corpus callosum an actual manifestation of Marchiafava-Bignami disease?

Neuroimaging of a 75-year-old lady demonstrated the characteristic patholog ical features of the Marchiafava-Bignami disease (MBD), which develops usua lly in chronic alcoholics. The onset of the neurological symptoms and signs were abrupt and similar to those seen in common ischemic vascular lesions. Our patient denied that she had consumed alcoholic beverage during her lif e. Laboratory results showed her liver enzymes were not elevated and a subs equent abdominal ultrasound examination revealed no liver pathology. The at tack responded fairly well to anti-ischemic therapy and a complete recovery was observed within a week. In this sense, her pathology cannot be conside red as a true MBD in spite of the presence of the CT and MRI findings of MB D. Our case seems to show that the CT and MRI findings in MBD are not speci fic because new imaging procedures reveal edematous, necrotic lesions that may have the appearance of MBD. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.